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  • Kris Krotiris

Hamstring Strains: Are They Really Preventable?

Updated: Jul 2

In almost all sporting codes that require high-speed running, kicking, and change of direction movements, hamstring injuries remain one of the most common reasons players spend time on the sidelines. Australian Rules Football, known for its demanding physical requirements, including high volumes of high-speed running, is a prime example. According to the AFL's recent annual injury report, which includes data from each football club, there is an estimated average of five new hamstring injuries per club each season. This trend persists despite the best efforts of top medical professionals and fitness coaches in the industry.

A professional AFL footballer having just injured his hamstring
A professional AFL footballer having just injured his hamstring

Predicting and preventing hamstring injuries is challenging due to the interplay of numerous potential factors that could influence injury risk. While some factors show strong, clear correlations with hamstring injury risk, others are still debated among physiotherapists, sports scientists, and fitness coaches. The most significant factors which are considered by most Sports Physiotherapists include:

  1. Previous Hamstring Injury: Athletes with a history of hamstring injuries have a significantly increased risk of recurrence.

  2. Reduced Hamstring Strength: Weak hamstrings are more vulnerable to injury when subjected to high-stress situations, such as during repeat maximal effort sprints. This remains particularly relevant for rehabilitation post injury and recurrence rates. Normative data however is not easily accessible for different population groups, therefore it can be difficult to define what is considered weak.

  3. Reduced Hip Strength: Weak hip muscles may increase the demands on the hamstrings, forcing them to compensate and increasing the risk of injury. The same issues are raised regarding what should be defined as weak.

  4. Imbalanced Quadriceps to Hamstring Strength Ratio: During a sprint, the hamstrings help slow down the lower leg during a phase called ‘terminal swing’, which is the final part of the leg’s forward motion before it descends to contact the ground. If the hamstrings are weak relative to the quadriceps, this imbalance might lead to an increased risk of injury.

  5. Inefficient Running Technique: Running mechanics can influence the distribution of load through the lower limb. Although no conclusive evidence exists of a direct correlation between running style and hamstring injury risk, certain traits, such as delayed ‘recovery’ of the push-off leg, are likely to increase load through the hamstring. This increased load can lead to greater fatigue, theoretically increasing the risk of injury.

  6. Inappropriate Training Loads: It is crucial to ensure appropriate programming that allows proper preparation before competition and consistent exposure to high-intensity and maximum-speed running, tailored to each athlete’s recovery ability.

  7. Inadequate Cardiovascular Fitness: Poor cardiovascular fitness leads to earlier and greater fatigue during games which is likely to increase the overall risk of injury.

  8. Dysfunction of Surrounding Joints and Muscles: Joint stiffness, joint hypermobility, muscle weakness, muscle tightness, or certain variations of lumbopelvic posture can influence movement efficiency, increasing the strain on the hamstrings, potentially making them more vulnerable to injury.

  9. Poor Recovery: Insufficient sleep and inadequate diet impair the body’s ability to recover from training and competition which may put the muscles and joints at higher risk of injury.

Why Do Hamstring Strains Continue To Occur?

The risk of hamstring injury is most likely influenced by the interplay of all the aforementioned factors. This complexity makes predicting and preventing injuries very challenging, despite our growing knowledge of risk factors and best-practice rehabilitation. In professional sports, athletes are pushed to their physical and psychological limits to gain a competitive edge. As training loads increase, it becomes crucial to control and optimise any modifiable risk factors to mitigate the increased risk associated with this extra workload. This is why professional sporting organisations invest significant time and money in player recovery and in tracking and managing player workloads during games and throughout the training week.


Despite these efforts, injuries can still occur if the balance of training load, recovery, and other factors is not maintained—something that some teams may only realise after experiencing a spate of injuries.


What Can You Do To Reduce Your Hamstring Strain Risk?

Many of the factors mentioned above can be modified to reduce your risk of suffering a hamstring injury. Whether you are a recreational or elite athlete, consider adding the Nordic Lower (see below) to your training program. This exercise has been proven to reduce hamstring injury risk by addressing the second point highlighted above: hamstring strength.


The Nordic Lower
The Nordic Lower Exercise: The athlete should try to maintain extended hips while lowering as slowly as possible to the ground by allowing the knees to bend.

To incorporate Nordic Lowers into your training routine, try the following gradual progression:

  • Week 1: 2 sets of 4 reps

  • Week 2: 2 sets of 5 reps

  • Week 3: 3 sets of 4 reps

  • Week 4: 3 sets of 5 reps

  • Week 5: 3 sets of 6 reps


If you are incorporating this exercise into your program for the first time and are in-season playing a competitive sport, be aware that you may experience some hamstring muscle soreness in the days following. While this is normal, it is best to allow at least three days for recovery between completing this exercise and playing your next game.


There are many other excellent exercises that should be included in a comprehensive strength and conditioning program to reduce your risk of hamstring injury. If you are currently recovering from a hamstring injury and need guidance, or if you would like an assessment and injury prevention program, you can call or SMS us at 0415 889 903 or email us at hello@prosportphysio.com.au


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